Complicación del drenaje endoscópico en un paciente con absceso retroorbitario: caso clínico / Complication of an endoscopic drainage on a patient with a retro-orbital abscess: report of a case

La rinosinusitis aguda, puede presentar una serie de complicaciones conocidas, un grupo de ellas son las complicaciones orbitarias. Se presenta la historia de un paciente que consultó por proptosis ocular, siendo diagnosticado un absceso subperióstico retroorbitario secundario a una rinosinusitis aguda. Se trató con técnica endoscópica, evoluciona con un hematoma retroorbitario que tuvo que ser drenado con un abordaje mixto, endoscópico y abierto, con buena evolución. Actualmente las complicaciones orbitarias de la rinosinusitis aguda tienen una baja prevalencia, y así, las complicaciones del drenaje endoscópico son aún menos frecuentes. Se destaca la importancia del conocimiento del manejo tanto endoscópico como abierto.

Among acute rhinosinusitis complications, the ones with orbital involvement are relevant. We present a case report of a patient who presented proptosis and was initially diagnosed with a retro ocular abscess as a complication to an acute rhinosinusitis. The abscess was drained with an endoscopic sinus surgery. On the fourth post-surgery day a retro ocular hematoma was diagnosed. The hematoma was treated with a combined open and endoscopic approach with a favorable outcome. In conclusion, even though orbital complications of rhinosinusitis nowadays have low prevalence, and orbital complications of their endoscopic management are even rarer, it is important for the otorhinolaryngologist to be familiar with their open, endoscopic, or combined surgical treatment.

Anticuerpo monoclonal anti-inmunoglobulina E en el tratamiento de la rinitis alérgica / Anti-immunoblobulin E monoclonal antibody in the treatment of allergic rhinitis

La rinitis alérgica (RA) es una enfermedad con alta incidencia a nivel mundial, sus síntomas están directamente relacionados con la exposición a un alérgeno ambiental que desencadena una cascada inflamatoria mediada por inmunoglobulina E. El tratamiento convencional actual de la RA consta del control ambiental, farmacoterapia e inmunoterapia; la reciente aparición de los anticuerpos monoclonales para el manejo de las enfermedades alérgicas parece ser prometedora. Estudios han demostrado que el Omalizumab, un anticuerpo monoclonal humanizado anti IgE, es capaz de modificar la respuesta inflamatoria dependiente de IgE, constituyéndose en una posible alternativa al manejo de la RA.

Allergic rhinitis (AR) is a disease with global high prevalence, its symptoms are directly related to environmental exposure to an allergen that triggers an inflammatory cascade mediated by Immunoglobulin E. The current standard treatment of AR consists of environmental control, pharmacotherapy and immunotherapy; the recent emergence of Monoclonal Antibodies for the management of allergic diseases appears promising. Studies have shown that Omalizumab, an anti-IgE humanized monoclonal antibody, is capable of modify the inflammatory IgE-dependent response, becoming a possible alternative to the management of AR.

Absceso de espacios profundos de cuello: a propósito de un caso en un niño / Infections of the deep neck spaces: a report of a case in a child

Infections of the deep neck spaces are low-frequency entities. They can be classified according to the anatomical space committed to peritonsillar, parapharyngeal, retropharyngeal, etc. They are clinically similar to other upper respiratory infection with symptoms like: fever, sore throat, dysphagia, dysphonia, cervical lymphadenitis. The diagnosis is made by clinical history, physical examination findings and imaging studies. The treatment consists in securing the airway, intravenous antibiotics and surgical drainage. We report the case of a ten months years old child who consulted at the Hospital Clínico Universidad de Chile by an upper respiratory infection associated with right cervical enlargement. The neck CT scan showed extensive soft tissue inflammatory changes of right lateral cervical region, supra and infrahyoid. The diagnosis of right deep neck space abscess was made. We began treatment with Cefotaxime / Clindamycin, and surgical drainage, showing favorable results.